Abdominal Pain, Age 11 and Younger

Topic Overview

Abdominal pain
in children is a common problem. About 1 out of 3 children is seen by a
doctor for abdominal pain by the time they are age 15, but only a small number of
these children have a serious problem.

Complaints of abdominal pain
are more common in children younger than 11 years and are often caused by
changes in eating and bowel habits. Most cases of abdominal pain are not
serious, and home treatment is often all that is needed to help relieve the
discomfort.

Abdominal pain in children is often frightening and
frustrating for parents. Many times it is hard to find the exact cause of a
child's abdominal pain. Pain without other symptoms that goes away completely
in less than 3 hours is usually not serious.

Generalized pain occurs in half of the abdomen or more. Localized pain is located in one area of the abdomen. Babies and toddlers often react
differently to pain than older children who can talk about their pain. A baby
may become fussy, draw his or her legs up toward the belly, or eat poorly.
Older children may be able to point to the area of the
pain and describe how severe it is.

Abdominal pain can occur one
time, or it can occur repeatedly over several months.
Recurrent abdominal pain (RAP) is a condition that
affects children ages 4 to 11.

Does your child have pain with a new bulge in the belly button or groin?

Yes

Pain with new bulge in navel or groin

No

Pain with new bulge in navel or groin

Is your child nauseated or vomiting?

Nauseated means you feel sick to your stomach, like you are going to vomit.

Yes

Nausea or vomiting

No

Nausea or vomiting

Within the past week, has your child had an injury to the abdomen, like a blow to the belly or a hard fall?

Yes

Abdominal injury within past week

No

Abdominal injury within past week

Since the injury, has there been any bleeding from the rectum, urethra, or vagina?

Yes

Bleeding from rectum, vaginal or urethra since injury

No

Bleeding from rectum, vaginal or urethra since injury

Is there a belly wound that is deeper than a scratch?

Yes

Penetrating wound

No

Penetrating wound

Do you think that the injury may have been caused by abuse?

Yes

Injury may have been caused by abuse

No

Injury may have been caused by abuse

Has your child vomited since the injury?

Yes

Vomited after injury

No

Vomited after injury

Is there pain just below the ribs?

Pain just below the ribs after an injury can be a symptom of serious damage to the liver or spleen.

Yes

Pain is below ribs

No

Pain is below ribs

Do you think your baby has a fever?

Yes

Fever

No

Fever

Did you take a rectal temperature?

Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious.

The amount of pain may change from minute to minute. Cramps often get better when you pass gas or have a bowel movement.

The pain may feel like a tightness or pinching in your belly.

The pain may be in one specific area or be over a larger area. It may move around.

Babies can quickly get dehydrated when they lose fluids because of problems like
vomiting or fever.

Symptoms of dehydration can range from mild to
severe. For example:

The baby may be fussy or cranky (mild dehydration),
or the baby may be very sleepy and hard to wake up (severe
dehydration).

The baby may have a little less urine than usual
(mild dehydration), or the baby may not be urinating at all (severe
dehydration).

You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For
example:

You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
dehydration).

You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
dehydration).

Severe dehydration means:

The baby may be very sleepy and hard to wake
up.

The baby may have a very dry mouth and very dry eyes (no
tears).

The baby may have no wet diapers in 12 or more hours.

Moderate dehydration means:

The baby may have no wet diapers in 6 hours.

The
baby may have a dry mouth and dry eyes (fewer tears than usual).

Mild dehydration means:

The baby may pass a little less urine than usual.

Severe dehydration means:

The child's mouth and eyes may be extremely dry.

The child may pass little or no urine for 12 or more
hours.

The child may not seem alert or able to think clearly.

The child may be too weak or dizzy to stand.

The
child may pass out.

Moderate dehydration means:

The child may be a lot more thirsty than
usual.

The child's mouth and eyes may be drier than
usual.

The child may pass little or no urine for 8 or more hours.

The child may feel dizzy when he or she stands or sits up.

Mild dehydration means:

The child may be more thirsty than
usual.

The child may pass less urine than usual.

If you're not sure if a child's fever is high, moderate, or
mild, think about these issues:

With a high fever:

The child feels very hot.

It is likely
one of the highest fevers the child has ever had.

With a moderate fever:

The child feels warm or hot.

You are
sure the child has a fever.

With a mild fever:

The child may feel a little warm.

You
think the child might have a fever, but you're not sure.

A baby that is extremely sick:

May be limp and floppy like a rag
doll.

May not respond at all to being held, touched, or talked
to.

May be hard to wake up.

A baby that is sick (but not extremely
sick):

May be sleepier than usual.

May not eat
or drink as much as usual.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.

Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.

Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.

Pain in children 3 years and older

Severe pain (8 to 10): The pain
is so bad that the child can't stand it for more than a few hours, can't sleep,
and can't do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.

Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and
sleep, but the child can tolerate it for hours or days.

Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.

Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury.

Symptoms of shock in a child may include:

Passing out.

Being very sleepy or hard
to wake up.

Not responding when being touched or talked to.

Breathing much faster than usual.

Acting confused.
The child may not know where he or she is.

Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar.

A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid.

Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black.

If you take a medicine that affects the blood's ability to clot, such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix), it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are:

Home Treatment

Most of the time, a child's
abdominal pain will get better with home treatment and the child will not need a visit to
a doctor.

Home treatment for abdominal pain often depends on other
symptoms that are present with the pain, such as diarrhea, nausea, or vomiting. See the Related Information section of this topic for information on some of these other symptoms.

Try the
following, one at a time in the order listed, if your child has mild abdominal
pain without other symptoms:

Have your child rest when he or she has mild
stomachaches. Most symptoms will get better or go away in 30
minutes.

Serve mild foods, such as rice, dry toast or
crackers, gelatin, or applesauce. Do not give your child spicy foods, other
fruits, or drinks that have caffeine or carbonation until 48 hours after all
symptoms have gone away. These foods may make your child's stomachache
worse.

Do not give your child any medicines without talking to the
doctor first. Medicines may mask the pain or make it worse.

Prevention

Abdominal pain in children can often be
prevented.

Abdominal pain in children is often caused by
irregular bowel habits. Become familiar with your child's normal bowel
patterns. Also, be aware of the size and consistency of your child's stools.
This will help to determine whether constipation is a problem. For information
on preventing constipation and establishing toilet training, see the topic
Constipation, Age 11 and Younger.

Try to
make sure your child has regular eating habits. Overeating is a common cause of
abdominal discomfort. Have your child eat slowly and stop when he or she feels
full. For more information, see the topic
Healthy Eating for Children.

Swallowing
air (aerophagia) can cause abdominal pain and a swollen abdomen. Your child may
also have a lot of belching or flatus. Limit chewing gum and carbonated
beverages to help prevent this. Many children swallow air when they are anxious
or frightened.

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